Making sense of feedback experiences: a multi‐school study of medical students' narratives
Abstract
Context: Until recently, the perspective of students in the feedback process has been ignored, with strategies for improvement focusing on the tutor and feedback delivery. We employed an original narrative interviewing approach to explore how medical students make sense of their experiences of feedback. Methods: A qualitative design was adopted employing three individual and 10 group interviews to elicit narratives of feedback experiences from 53 medical students at three 5‐year undergraduate programmes in the UK during 2011. Thematic analysis was undertaken of students' understandings of feedback and of their narratives of positive and negative experiences of feedback at medical school. In addition, thematic and discourse analysis of the linguistic and paralinguistic features of talk within the narratives was conducted. Results: Students typically constructed feedback as a monologic process that happened ‘to’ them rather than ‘with’ them. They shared 352 distinct narratives of feedback experiences, which were rich in linguistic and paralinguistic features of talk. Through the analysis of the interplay between the ‘whats’ and ‘hows’ of student talk, i.e. emotion, pronominal and metaphoric talk and laughter, we were able to understand how students find meaning in their experiences. Students used laughter as a coping strategy, emotion talk as a means to convince the audience of the impact of feedback, pronominal and metaphoric talk to describe their relationship (often adversarial) with their feedback providers and to communicate feelings that they might otherwise struggle to articulate. Conclusions: This research extends current feedback literature by focusing on medical students' lived experiences of feedback and their emotional impact through narrative. We go on to discuss the educational implications of our findings and to make recommendations for improvement of the feedback process for students, tutors and for institutions.
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Medical students value informal verbal feedback more than formal workplace-based assessment with written feedback.
“Medical students have been found to value informal verbal feedback more than formal workplace-based assessment (WBA) with written feedback [66, 67].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [66]
Cites
Hattie, J., & Timperley, H. (2007) · Review of Educational Research · doi:10.3102/003465430298487 · Cited by 12,905 · see citing works
(1998) · Cited by 9,332 · see citing works
Kluger, A. N., & DeNisi, A. (1996) · Psychological Bulletin · doi:10.1037/0033-2909.119.2.254 · Cited by 5,882 · see citing works
Nicol, D. J., & Macfarlane‐Dick, D. (2006) · Studies in Higher Education · doi:10.1080/03075070600572090 · Cited by 5,846 · see citing works
Qualitative data analysis for applied policy research
Ritchie, J., & Spencer, L. (2010) · Analyzing qualitative data · doi:10.4324/9780203413081_chapter_9 · Cited by 4,800 · see citing works
Narrative Methods for the Human Sciences
(2008) · Gender in Management An International Journal · doi:10.1108/17542410810897562 · Cited by 3,784 · see citing works
Focus Group Interviews in Education and Psychology
Vaughn, S. R., Schumm, J. S., & Sinagub, J. (1996) · Sage eBooks · doi:10.4135/9781452243641 · Cited by 1,479 · see citing works
Feedback in Clinical Medical Education
Ende, J. (1983) · JAMA · doi:10.1001/jama.1983.03340060055026 · Cited by 1,259 · see citing works
Differing perceptions in the feedback process
Carless, D. (2006) · Studies in Higher Education · doi:10.1080/03075070600572132 · Cited by 1,102 · see citing works
From monologue to dialogue: Improving written feedback processes in mass higher education.
Nicol, D. (2010) · Assessment & Evaluation in Higher Education · doi:10.1080/02602931003786559 · Cited by 1,060 · see citing works
Some Further Steps in Narrative Analysis
Labov, W. (1997) · Journal of Narrative and Life History · doi:10.1075/jnlh.7.49som · Cited by 782 · see citing works
What is feedback in clinical education?
Van De Ridder, J. M. M., Stokking, K. M., McGaghie, W. C., & Ten Cate, O. T. J. (2008) · Medical Education · doi:10.1111/j.1365-2923.2007.02973.x · Cited by 686 · see citing works
Barbour, R. S. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02200.x · Cited by 582 · see citing works
Effectiveness of feedback: the students’ perspective
Poulos, A., & Mahony, M. J. (2008) · Assessment & Evaluation in Higher Education · doi:10.1080/02602930601127869 · Cited by 544 · see citing works
Teaching and learning in ambulatory care settings
Irby, D. M. (1995) · Academic Medicine · doi:10.1097/00001888-199510000-00014 · Cited by 508 · see citing works
Branch, W. T., & Paranjape, A. (2002) · Academic Medicine · doi:10.1097/00001888-200212000-00005 · Cited by 506 · see citing works
Giving feedback in clinical settings
Cantillon, P., & Sargeant, J. (2008) · BMJ · doi:10.1136/bmj.a1961 · Cited by 460 · see citing works
Functions of humor in the conversations of men and women
Hay, J. B. (2000) · Journal of Pragmatics · doi:10.1016/s0378-2166(99)00069-7 · Cited by 458 · see citing works
The feedback triangle and the enhancement of dialogic feedback processes
Yang, M., & Carless, D. (2013) · Teaching in Higher Education · doi:10.1080/13562517.2012.719154 · Cited by 414 · see citing works
Facilitating productive use of feedback in higher education
Jonsson, A. (2013) · Active Learning in Higher Education · doi:10.1177/1469787412467125 · Cited by 414 · see citing works
Giving feedback in medical education: Verification of recommended techniques
Hewson, M. G., & Little, M. L. (1998) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.1998.00027.x · Cited by 409 · see citing works
Eva, K. W., Armson, H., Holmboe, E., Lockyer, J., Loney, E., Mann, K., & Sargeant, J. (2012) · Advances in Health Sciences Education · doi:10.1007/s10459-011-9290-7 · Cited by 402 · see citing works
Stories as data, data as stories: making sense of narrative inquiry in clinical education*
Bleakley, A. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02126.x · Cited by 385 · see citing works
Emotion and memory narrowing: A review and goal-relevance approach
Levine, L. J., & Edelstein, R. S. (2009) · Cognition & Emotion · doi:10.1080/02699930902738863 · Cited by 380 · see citing works
Performing identities in illness narrative: masculinity and multiple sclerosis
Riessman, C. K. (2003) · Qualitative Research · doi:10.1177/146879410300300101 · Cited by 343 · see citing works
How positive and negative feedback motivate goal pursuit.
Fishbach, A., Eyal, T., & Finkelstein, S. R. (2010) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2010.00285.x · Cited by 304 · see citing works
Emotions and Narrative Analysis: A Methodological Approach
Kleres, J. (2010) · Journal for the Theory of Social Behaviour · doi:10.1111/j.1468-5914.2010.00451.x · Cited by 273 · see citing works
The Transformative Power of Narrative in Second Language Teacher Education
Johnson, K. E., & Golombek, P. R. (2011) · TESOL Quarterly · doi:10.5054/tq.2011.256797 · Cited by 263 · see citing works
Learning from clinical work: the roles of learning cues and credibility judgements
Watling, C., Driessen, E., van der Vleuten, C. P. M., & Lingard, L. (2012) · Medical Education · doi:10.1111/j.1365-2923.2011.04126.x · Cited by 261 · see citing works
Remembering what you feel: Effects of emotion on memory.
Laird, J. D., Wagener, J. J., Halal, M., & Szegda, M. J. (1982) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.42.4.646 · Cited by 179 · see citing works
Educational feedback in the operating room: A gap between resident and faculty perceptions.
Jensen, A. R., Wright, A. S., Kim, S., Horvath, K. D., & Calhoun, K. E. (2012) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2011.08.019 · Cited by 174 · see citing works
Sargeant, J., Mann, K., & Ferrier, S. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02124.x · Cited by 174 · see citing works
'I Might as Well Give Up': Self-esteem and mature students' feelings about feedback on assignments
Young, P. (2000) · Journal of Further and Higher Education · doi:10.1080/030987700750022325 · Cited by 165 · see citing works
Feedback falling on deaf ears: residents' receptivity to feedback tempered by sender credibility
Bing-You, R. G., Paterson, J., & Levine, M. A. (1997) · Medical Teacher · doi:10.3109/01421599709019346 · Cited by 161 · see citing works
De, S. K., Henke, P. K., Ailawadi, G., Dimick, J. B., & Colletti, L. M. (2004) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2004.08.025 · Cited by 157 · see citing works
Features of assessment learners use to make informed self-assessments of clinical performance.
Sargeant, J., Eva, K. W., Armson, H., Chesluk, B., Dornan, T., Holmboe, E., Lockyer, J. M., Loney, E., Mann, K. V., & van der Vleuten, C. P. M. (2011) · Medical Education · doi:10.1111/j.1365-2923.2010.03888.x · Cited by 154 · see citing works
Student–teacher connection in clinical nursing education
Gillespie, M. (2002) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2002.02131.x · Cited by 154 · see citing works
Feedback, the various tasks of the doctor, and the feedforward alternative
Kluger, A. N., & Van Dijk, D. (2010) · Medical Education · doi:10.1111/j.1365-2923.2010.03849.x · Cited by 134 · see citing works
Theorising how student teachers form their identities in initial teacher education
Atkinson, D. (2004) · British Educational Research Journal · doi:10.1080/01411920410001689698 · Cited by 132 · see citing works
Narrative, emotion and action: analysing ‘most memorable’ professionalism dilemmas
Rees, C. E., Monrouxe, L. V., & McDonald, L. A. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04302.x · Cited by 129 · see citing works
Self-citationFormative feedback to students: the mismatch between faculty perceptions and student expectations
Perera, J. P. C. C. G. S. L. P., Lee, N., Win, K., Perera, J., & Wijesuriya, L. I. (2008) · Medical Teacher · doi:10.1080/01421590801949966 · Cited by 129 · see citing works
Turning the medical gaze in upon itself: Root cause analysis and the investigation of clinical error
Iedema, R. A. M., Jorm, C. M., Long, D., Braithwaite, J., Travaglia, J., & Westbrook, M. T. (2005) · Social Science & Medicine · doi:10.1016/j.socscimed.2005.08.049 · Cited by 118 · see citing works
Complexity, cues and relationships: Student perceptions of feedback
Pokorny, H., & Pickford, P. (2010) · Active Learning in Higher Education · doi:10.1177/1469787409355872 · Cited by 114 · see citing works
Perceptions of medical school faculty members and students on clinical clerkship feedback
Gil, D. H., Heins, M., & Jones, P. (1984) · Academic Medicine · doi:10.1097/00001888-198411000-00003 · Cited by 110 · see citing works
Monrouxe, L. V., & Rees, C. E. (2011) · Advances in Health Sciences Education · doi:10.1007/s10459-011-9342-z · Cited by 107 · see citing works
Self-citationUnderstanding responses to feedback: the potential and limitations of regulatory focus theory
Watling, C., Driessen, E., van der Vleuten, C. P. M., Vanstone, M., & Lingard, L. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04209.x · Cited by 99 · see citing works
Norcini, J. J. (2009) · Medical Education · doi:10.1111/j.1365-2923.2009.03542.x · Cited by 91 · see citing works
Rees, C. E., Monrouxe, L. V., & Wilkinson, C. E. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.03.044 · Cited by 85 · see citing works
Self-citationMaturational differences in undergraduate medical students’ perceptions about feedback.
Murdoch‐Eaton, D., & Sargeant, J. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04291.x · Cited by 83 · see citing works
Lovers of aids victims: Psychosocial stresses and counseling needs
Geis, S. B., Fuller, R. L., & Rush, J. (1986) · Death Studies · doi:10.1080/07481188608252798 · Cited by 70 · see citing works
McKimm, J. (2009) · British Journal of Hospital Medicine · doi:10.12968/hmed.2009.70.3.40570 · Cited by 66 · see citing works
Rees, C. E., Monrouxe, L. V., & Cleland, J. (2008) · Assessment & Evaluation in Higher Education · doi:10.1080/02602930802071098 · Cited by 54 · see citing works
Self-citationEraut, M. R. (2006) · Learning in Health and Social Care · doi:10.1111/j.1473-6861.2006.00129.x · Cited by 50 · see citing works
Narrative as a Teaching Strategy
Butcher, S. E. (2006) · Journal of correctional education · Cited by 46 · see citing works
Rees, C. E., & Monrouxe, L. V. (2009) · Communication & Medicine · doi:10.1558/cam.v5i2.171 · Cited by 37 · see citing works
Self-citationLomas, T., Cartwright, T., Edginton, T. L., & Ridge, D. (2012) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/1363459312451178 · Cited by 34 · see citing works
Murdoch‐Eaton, D. G. (2012) · Medical Education · doi:10.1111/j.1365-2923.2012.04278.x · Cited by 18 · see citing works
Feedback Process between Faculty and Students
Sostok, M. A., Coberly, L., & Rouan, G. W. (2002) · Academic Medicine · doi:10.1097/00001888-200203000-00020 · Cited by 16 · see citing works
ABCDEFG IS – The Principle of Constructive Feedback
Bhattarai, M. D. (2007) · Journal of Nepal Medical Association · doi:10.31729/jnma.293 · Cited by 9 · see citing works
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Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education.
Lefroy, J., Watling, C., Teunissen, P. W., & Brand, P. (2015) · Perspectives on Medical Education · doi:10.1007/s40037-015-0231-7 · Cited by 347 · see citing works
Feedback and the educational alliance: Examining credibility judgements and their consequences.
Telio, S., Regehr, G., & Ajjawi, R. (2016) · Medical Education · doi:10.1111/medu.13063 · Cited by 231 · see citing works
Bakke, B. M., Sheu, L., & Hauer, K. E. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003012 · Cited by 50 · see citing works
Grades in formative workplace‐based assessment: a study of what works for whom and why
Lefroy, J., Hawarden, A., Gay, S. P., McKinley, R. K., & Cleland, J. (2015) · Medical Education · doi:10.1111/medu.12659 · Cited by 31 · see citing works
- Authors
- Urquhart, L. M., Rees, C. E., & Ker, J. S.
- Affiliations
- University of Dundee (GB)
- Corresponding author
- Urquhart, Lynn M
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2014-01-12
- Volume
- 48
- Issue
- 2
- Pages
- 189-203
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W1990355333
- Cited by
- 83
- References
- 59
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 4 · 2023: 6 · 2022: 6 · 2021: 9 · 2020: 10 · 2019: 9 · 2018: 9 · 2017: 6 · 2016: 6 · 2015: 6 · 2014: 3
- FWCI
- 6.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- Discovery Research Portal (University of Dundee) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Student Assessment and Feedback
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- feedback, medical students, narrative interviews, paralinguistic features, laughter, emotion talk, metaphor, tutor-student relationship, undergraduate medical education
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Attitude of Health Personnel, Education, Medical, Emotions, Feedback, Female, United Kingdom, Humans, Language, Laughter, Male, Schools, Medical, Students, Medical, Teaching, Narration, Qualitative Research, Young Adult
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